April 2019 Health Newsletter

print newsletter
Current Articles

» Chiropractic Reduces Falling Risk in the Elderly
» Live in a High-Income Country? Donít Expect the Highest Life Expectancy
» Young and Overweight? Your Heart May Suffer
» ADHD May Be on the Rise in U.S. Children

Chiropractic Reduces Falling Risk in the Elderly  

 

Chiropractic Care Improves Senses and Reduces Risks of

Falling in the Elderly Population

 

By: Mark Studin DC, FASBE(C), DAAPM, DAAMLP

William J. Owens DC, DAAMLP

 

As our population ages, our most senior are being told that their heart diseases or cancers won’t be as likely to cause death as sequella from a fall. Therefore, doctors are urging that sect of population to rely more and more on canes, walkers and other devices to help offer greater support when balance issues become even slightly problematic. According to Holt et. Al (2016) “Falls account for more than 80% of injury related hospital admissions in people older than 65 years and they are the leading cause of injury related death in older adults. Approximately 30%-40% of community-dwelling older adults suffer from at least 1 fall per year.” (pg. 267)

 

Holt et. al. listed the following risks associated with falls

  1. Lower limb weakness
  2. Recent History of Falling
  3. Gait Deficits
  4. Deterioration of the sensorimotor system that occurs regularly with normal aging

 

The National Institute of Health (NIH) expanded the list of risk factors in older adults to include:

  1. Muscle weakness
  2. Balance and gait
  3. Blood pressure drops
  4. Postural hypotension
  5. Reflexes slower
  6. Foot problems
  7. Sensory problems
  8. Vision issues
  9. Confusion
  10. Medications

(http://nihseniorhealth.gov/falls/causesandriskfactors/01.html)

 

Comparatively speaking, both the Holt et. Al. and the NIH are in agreement that falling can be a multifactorial issue with often no single cause or solution. However, if an older person, who has one or more of the above risk factors can minimize those risks, the likelihood of falling can be decreased and potentially extend their life. Holt et. al. continued “There is however, a growing body of basic science evidence that suggests that chiropractic care may influence sensory and motor systems that potentially have an impact on some of the neuromuscular risk factors associated with falling.” (pg. 268) In short, the evidence has suggested that chiropractic can reduce the risk of falling in older adults.

 

Holt et. al. found that the mechanisms where chiropractic may influence sensorimotor functions are:

  1. Neuroplastic processes in the central nervous system through altered afferent input.
  2. Pain and altered cognition as a result with respect to attention focus and physical function
  3. Muscle strength and muscle activity patters
  4. Deterioration of the sensorimotor system that occurs regularly with normal aging

Looking at those neuroplastic processes or effects of chiropractic on the central nervous system, Gay et al. (2014) reported, “…pain-free volunteers processed thermal stimuli applied to the hand before and after thoracic spinal manipulation (a form of MT).  What they found was that after thoracic manipulation, several brain regions demonstrated a reduction in peak BOLD [blood-oxygen-level–dependent] activity. Those regions included the cingulate, insular, motor, amygdala and somatosensory cortices, and the PAG [periaqueductal gray regions]” (p. 615). In other words, thoracic adjustments produced direct and measureable effects on the central nervous system across multiple regions, which in the case of the responsible for the processing of emotion (cingulate cortex, aka limbic cortex) are regarding the insular cortex which also responsible for regulating emotion as well has homeostasis. The motor cortex is involved in the planning and execution of voluntary movements, the amygdala’s primary function is memory and decision making (also part of the limbic system), the somatosensory cortex is involved in processing the sense of touch (remember the homunculus) and, finally, the periaqueductal gray is responsible for descending pain modulation (the brain regulating the processing of painful stimuli).

 

This is a major step in showing the global effects of the chiropractic adjustment, particularly those that have been observed clinically, but not reproduced in large studies.  “The purpose of this study was to investigate the changes in FC [functional changes] between brain regions that process and modulate the pain experience after MT [manual therapy]. The primary outcome was to measure the immediate change in FC across brain regions involved in processing and modulating the pain experience and identify if there were reductions in experimentally induced myalgia and changes in local and remote pressure pain sensitivity” (Gay et al., 2014, p. 615). 

 

Coronado et al. (2012) reported that, “Reductions in pain sensitivity, or hypoalgesia, following SMT [spinal manipulative therapy or the chiropractic adjustment] may be indicative of a mechanism related to the modulation of afferent input or central nervous system processing of pain” (p. 752). “The authors theorized the observed effect related to modulation of pain primarily at the level of the spinal cord since (1) these changes were seen within lumbar innervated areas and not cervical innervated areas and (2) the findings were specific to a measure of pain sensitivity (temporal summation of pain), and no other measures of pain sensitivity, suggesting an effect related to attenuation of dorsal horn excitability and not a generalized change in pain sensitivity” (Coronado et al., 2012, p. 752).These findings indicate that a chiropractic spinal adjustment affects the dorsal horns at the root levels which are located in the central nervous system.  This is the beginning of the “big picture” since once we identify the mechanism by which we can positively influence the central nervous system, we can then study that process and its effects in much more depth.    

 

One of the main questions asked by Corando et al. (2012) “…was whether SMT (chiropractic adjustments) elicits a general response on pain sensitivity or whether the response is specific to the area where SMT is applied. For example, changes in pain sensitivity over the cervical facets following a cervical spine SMT would indicate a local and specific effect while changes in pain sensitivity in the lumbar facets following a cervical spine SMT would suggest a general effect. We observed a favorable change for increased PPT [pressure pain threshold] when measured at remote anatomical sites and a similar, but non-significant change at local anatomical sites. These findings lend support to a possible general effect of SMT beyond the effect expected at the local region of SMT application (p. 762).

 

The above mechanisms take the effects of chiropractic care out of the realm of theory and validates the processes through which chiropractic works based upon the scientific evidence (literature).

 

 

Holt et. Al found that outcomes measured for both sensorimotor and quality of life increased with chiropractic care. The primary outcomes of improvement choice stepping reaction time (CSRT)and sound-induced flash illusion. The CSRT involves feet placement in a timed scenario and sound-induced flash illusion involves multisensory processing to ascertain reaction to perceived illusions. Both have been significantly related to older populations and falling. Although the results of this study has its limitations, as many studies do. Holt concluded” The results of this trial indicated that aspects of sensorimotor integration and multisensory integration associated with fall risk improved in a group of community-dwelling older adults receiving chiropractic care. The chiropractic group also displayed small, statistically significant improvements in health-related quality of life related to physical health when compared with a “usual care” control. These results support previous research which suggests that chiropractic care may alter somatosensory processing and sensorimotor integration.” (pg. 277)  

 

As with many of our articles from here forward, I would like to leave you with a last and seemingly unrelated statement.  I felt it was important to add this at the end since many of our critics negatively portray the safety of chiropractic care.  This statement shall put that to rest leaving only personal biases left standing. Whedon, Mackenzie, Phillips, and Lurie (2015) based their study on 6,669,603 subjects and after the unqualified subjects had been removed from the study, the total patient number accounted for 24,068,808 office visits. They concluded, “No mechanism by which SM [spinal manipulation] induces injury into normal healthy tissues has been identified” (Whedon et al., 2015, p. 5). This study supersedes all the rhetoric about chiropractic and stroke and renders an outcome assessment to help guide the triage pattern of mechanical spine patients.

 

References:

  1. Holt K., Haavik H., Lee A., Murphy B., Elley C., (2016) Effectiveness of Chiropractic Care to Improve Sensorimotor Function Associated with Falls Risk in Older People: A Randomized Controlled Trial, Journal of Manipulative and Physiological Therapeutics, 39(4) 267-278
  2. Falls and Older Adults, Causes and Risk Factors (n.d.) National Institute of Health, retrieved from: http://nihseniorhealth.gov/falls/causesandriskfactors/01.html
  3. Gay, C. W., Robinson, M. E., George, S. Z., Perlstein, W. M., & Bishop, M. D. (2014). Immediate changes after manual therapy in resting-state functional connectivity as measured by functional magnetic resonance imaging in participants with induced low back pain.Journal of Manipulative and Physiological Therapeutics, 37(9), 614-627.
  4. Coronado, R. A., Gay, C. W., Bialosky, J. E., Carnaby, G. D., Bishop, M. D., & George, S. Z. (2012). Changes in pain sensitivity following spinal manipulation: A systematic review and meta-analysis, Journal of Electromyography Kinesiology, 22(5), 752-767.
  1. Whedon, J. M., Mackenzie, T. A., Phillips, R. B., & Lurie, J. D. (2015). Risk of traumatic injury associated with chiropractic spinal manipulation in Medicare Part B beneficiaries aged 66-69 years. Spine, 40(4), 264-270.

Author:Mark Studin DC, FASBE(C), DAAPM, DAAMLP and William J. Owens DC, DAAMLP
Source:US Chiropractic Directory
Copyright:2016 2016


page toppage toppage top


Live in a High-Income Country? Donít Expect the Highest Life Expectancy  

Two new studies are revealing some startling facts about recent life expectancies in high-income countries like the U.S.: They're declining, but for surprising reasons. The first of the studies examined life expectancy trends among 18 countries with high income. Overwhelmingly, most of them experienced simultaneous declines in 2015 for the first time in decades. In the U.S., drug overdoses due to the opioid epidemic are to blame for a large number of young adult deaths. In other high-income countries, a harsh flu was mostly behind declining life expectancies during the 2014-2015 season. Most were able to rebound their rates during 2015-2016, but the U.K. and the U.S. were not among them. Meanwhile, a second study adds that the opioid epidemic is just the beginning Ė deaths from alcohol abuse and suicide are also on the rise in the U.S., not to mention death during middle age due to diseases of the organs, including the heart, digestive system, and lungs. The second study also suggests that lower life expectancies may have psychological and socioeconomic origins. In short, what causes people in low socioeconomic groups to make bad health choices like smoking, abusing alcohol, and eating unhealthy foods?† The German researchers behind the study, from the Max Planck Institute for Demographic Research, suggest that stress from income inequality, social exclusion, and more can be the starting point.

Author:ChiroPlanet.com
Source:The BMJ, online August 22, 2018.
Copyright:ProfessionalPlanets.com LLC 2019


page toppage toppage top


Young and Overweight? Your Heart May Suffer  

Young adults who are overweight are at high risk for high blood pressure and damage to the heart, just like older adults. According to a study from the U.K.'s University of Bristol, the correlation between a high BMI (body mass index) and cardiovascular issues applies to young people, too. To come to their conclusions, researchers studied data collected from over 3,000 young people born during the '90s, who were 17 years old when the study took place. Researchers also looked at the cardiovascular scans of 400 high-risk, 21-year-old adults. The 17-year-olds' average BMI was in the so-called "healthy" range. The average blood pressure of the group was also in the range considered "healthy" (under 130 mmHg for a systolic reading and under 80 mmHg for a diastolic reading).† In general, young adults who had higher BMIs in the study also had a better chance of developing high blood pressure. They additionally found that having a high BMI correlates to a higher left ventricular mass index (meaning the left ventricle of the heart is enlarged). This means that the young adults who weighed more correspondingly had more blood pumping through their bodies every minute. Over time, this may lead to a variety of heart issues, including a thickened heart muscle and high blood pressure. According to a Harvard Medical School researcher, this may be because those at a higher weight have bodies with higher metabolic demands. They may also have more inflammation due to their increased amount of fat cells.

Author:ChiroPlanet.com
Source:Circulation, online July 30, 2018.
Copyright:ProfessionalPlanets.com LLC 2019


page toppage toppage top


ADHD May Be on the Rise in U.S. Children  

According to a new study published in JAMA Network Open, diagnoses of children with ADHD (attention-deficit/hyperactivity disorder) have increased significantly since 1997. Researchers found that the diagnosis rate for children with ADHD increased from 6.1% in 1997 to 10.2% in 2016. However, according to Dr. Wei Bao, there could be lots of reasons for this dramatic rise. For example, doctors are much better at diagnosing ADHD than they were 20 years ago. Dr. Bao also said that more people today are aware of the condition and its symptoms, which can lead to more kids getting screened and subsequently diagnosed. Bao and his fellows are researchers at the College of Public Health at the University of Iowa. They came to their conclusions by reviewing the National Health Interview Survey over 20 years. In particular, they honed in on answers to one question: Whether survey-takers' children had ever been diagnosed with ADHD or ADD (attention-deficit disorder). For scope, the most recent iteration of the survey from 2015-2016 collected data on over 18,000 children from age 4-17. Of that number, nearly 2,000 received an ADHD diagnosis. Though the research results are startling, experts advise parents and doctors to take the increase in children with ADHD with a grain of salt. This is because ADHD is commonly misdiagnosed.

Author:ChiroPlanet.com
Source:JAMA Network Open, online August 31, 2018.
Copyright:ProfessionalPlanets.com LLC 2019


page toppage toppage top


Articles 1-4 of 4 << first < previous next > last >

Back To Action Chiropractic Center | Dr. Jerry Dreessen and Dr. Jason Gilmore
6603 220th Street SW Suite 100 | Mountlake Terrace, Washington 98043
Tel: (425) 670-2600 | Fax: (425) 778-7073
Office Hours - call for appointment times
Mountlake Terrace Washington Chiropractor Chiropractors Chiropractic Doctors
Privacy Notice: Website - Clinic

Copyright Notice